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Nationwide Shortages Looming for Respirators, Masks, Gowns: Expert Poll

Nurse with patient on respirator

FRIDAY, March 27, 2020 (HealthDay News) -- Nearly half of U.S. health care facilities are already or nearly out of respirators worn by staff to protect against infection as they care for COVID-19 patients, a new survey shows.

One in five facilities have no respirators and 28% are almost out of the filtering face masks, which provide advanced protection against viral infection, the online survey of 1,140 infection preventionists found.

The survey also found shortages in face shields, hospital masks, goggles and other personal protective equipment (PPE) that hospital workers wear as they treat people infected with the coronavirus.

"The results paint a disturbing and alarming picture," said Katrina Crist, chief executive officer of the Association for Professionals in Infection Control and Epidemiology (APIC), which sponsored the survey. "Shortages of critical PPE and disinfection supplies are jeopardizing our ability to safely treat patients and protect the health care workers who put their lives on the line every day."

Respirators are running short because they aren't needed as often in normal times, and so aren't kept in heavy stock, said Benjamin Klos, an instructor and registered nurse at the West Virginia University School of Nursing.

"Where a health care worker might use 50, 100, 150 gloves per day, they may only use 10 to 20 masks per week. So, less respiratory PPE equipment is kept on hand," Klos said in a university news release. "The problem is that the respiratory PPE is now being used as frequently as gloves."

The survey also found that of PPE stores:

  • Plastic face shields are nearly out in 37% of facilities surveyed, and completely out in 13%.
  • Nearly one in three facilities are almost out of face masks, and 48% are running low.
  • Two in five facilities are completely or almost out of safety goggles, and another 38% are running low.
  • About one in four facilities are completely or nearly out of hospital gowns, and 44% are running low.

Citing these shortages, APIC issued a call Friday for President Donald Trump to immediately activate the Defense Production Act, which gives the president the power to pressure private industry into producing supplies for the national defense.

Feds need to step up with supplies

Private and community donations and do-it-yourself efforts have been more helpful than the U.S. federal government in providing PPE to facilities in need, the survey found.

Only about 12% of facilities have been able to get supplemental PPE from federal resources, compared with 25% that have drawn from local donations and 17% from do-it-yourself efforts to cobble together masks and gowns, results show. State and local governments have supplied PPE to 29% of facilities surveyed.

"The federal government must act now to secure more PPE and coordinate distribution where it's needed most," said APIC President Connie Steed. "Every minute matters. Every minute wasted put more lives at risk. We need to help those on the front line."

Not only do the feds need to intervene, but hospitals need to be given dates when they can expect delivery of needed supplies, to help reassure health care workers who are fearful of their own safety on the job, Steed said.

"Soon is not really good enough. We need them immediately," Steed said.

The concern over the PPE shortage is twofold. Health care workers who get sick won't be able to help care for others, and there also is some concern workers will stop showing up if they become too frightened for their own safety.

Health care workers don't wear this stuff for fun, Klos said.

"The PPE is cumbersome and hot. I compare it to a self-sauna with little ventilation," Klos said.

Nurses and doctors can't wash and reuse their masks and gowns because there's no evidence it would effectively prevent the spread of disease, he said.

"Self-cleaning PPE may just damage the equipment and make it less useful," Klos said. "A nurse could wear a mask to see patient A, clean the mask and go see patient B. But if the cleaning process is ineffective, the disease is potentially spread from patient A to patient B via the mask."

Shortage of sanitizer, cleaning products also seen

Steed, director of infection prevention and control with Prisma Health-Upstate in Greenville, S.C., said her organization is trying to use ultraviolet disinfection to extend the life of their supply of respirators and other PPE.

They're also planning to use hydrogen peroxide mist to disinfect respirators, Steed said.

These shortages also include many sanitizers and cleaning products upon which facilities rely to prevent the spread of coronavirus.

Hand sanitizer is in short supply at more than one in four facilities. About 3% are out and 26% are nearly out, while another 43% are running low, according to the survey.

Meanwhile, about 17% of facilities are critically low or out of cleaning and disinfection products, and 39% are running low.

In every community, people are scouring store rooms to find PPE that can be forwarded to hospitals, nursing homes and long-term care facilities.

On Thursday, Oregon State University said it had collected more than 12 pallets of PPE, including nearly 200,000 pairs of gloves and more than 8,000 face masks, and would be donating the lot to health care workers.

And Washington National Cathedral found boxes containing more than 5,000 surgical masks tucked away in its crypts, purchased in 2006 during an earlier health scare, officials told the Washington Post on Thursday. The masks were split between Georgetown University Hospital and Children's National Hospital, both in Washington, D.C.

Fanatics, the company that manufactures Major League Baseball uniforms, has redirected its Pennsylvania factory to make protective masks and gowns with the same polyester mesh used for team jerseys, the Post reported Friday. Its goal is to produce 1 million masks and gowns within the next couple of months.

Hospitals are gladly accepting donations of homemade masks, but these likely will be used to protect families visiting sick relatives or newly released patients headed home, said APIC President-elect Ann Marie Pettis, director of infection prevention for University of Rochester Medicine in Rochester, N.Y.

New York is the center of the U.S. COVID-19 epidemic; nearly half of all confirmed cases are in that state.

"Cases and deaths are rising by the day, and honestly it really feels like there's no light at the end of the tunnel," Pettis said. "Given how rapidly this virus is spreading, other states and cities will in all probability soon face the same situation."

More information

The U.S. National Institutes of Health has more about personal protective equipment.

SOURCES: Katrina Crist, M.B.A., chief executive officer, Association for Professionals in Infection Control and Epidemiology; Connie Steed, M.S.N., R.N., director, infection prevention and control, Prisma Health-Upstate, Greenville, S.C.; Ann Marie Pettis, R.N., B.S.N., director, infection prevention, University of Rochester Medicine, Rochester, N.Y.; West Virginia University, news release, March 26, 2020; Washington Post
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